scholarly journals Radio-surgical correlation of chronic suppurative otitis media

2019 ◽  
Vol 6 (1) ◽  
pp. 118
Author(s):  
Yogeesha B. S. ◽  
Nagaraj Maradi ◽  
Ravi Shekhar ◽  
Rohini D. Urs
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Predictive Value ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
High Resolution Computed Tomography ◽  
Suppurative Otitis Media ◽  
Fallopian Canal ◽  
Ear Ossicles ◽  
Kappa Value

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) because of disease nature and location of vital structures like middle ear ossicles, facial nerve, and lateral semicircular canal poses clinical as well as radiological challenge in diagnosis, especially the squamosal variety. Hence this study to evaluate radio-surgical correlation in cases of CSOM.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 92 case records who met the inclusion criteria. Their pre-operative high-resolution computed tomography (HRCT) temporal bone imaging was evaluated for erosion of the ossicular chain and the fallopian canal. This was correlated with the surgical findings noted intra-operatively. The appropriate statistical analysis was carried out. The radio-surgical correlation was evaluated by Cohen’s kappa value.  </p><p class="abstract"><strong>Results:</strong> The kappa value for status of ossicular chain was 0.805 and 0.384 for status of fallopian canal. HRCT imaging had a positive predictive value and negative predictive value of 94.3% and 85.3% respectively, in detecting ossicular chain erosion. In detecting fallopian canal erosion, HRCT showed a sensitivity of 33.3%. Analysing the individual ossicles, we found kappa to be 0.266 for malleus, 0.463 for incus and 0.827 for stapes.</p><p class="abstract"><strong>Conclusions:</strong> There was excellent radio-surgical correlation for ossicular chain erosion while it was poor for fallopian canal erosion. HRCT showed excellent radio-surgical correlation for stapes, moderate for incus and poor for malleus. In-spite of its shortcomings in differentiating cholesteatoma and non-cholesteatomatous pathologies of the middle ear cleft, HRCT imaging plays a key role in assessing the status of the ossicles and fallopian canal.</p><p> </p>

scholarly journals Scanning Electron Microscopy in the Evaluation of Defects to the Ossicular Chain in the Course of Chronic Otitis Media

2019 ◽  
pp. 014556131987391
Author(s):  
Agnieszka Wiatr ◽  
Katarzyna Swiezy ◽  
Jacek Skladzien ◽  
Maciej Wiatr
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Chronic Inflammation ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Suppurative Otitis Media ◽  
Ear Ossicles ◽  
Scanning Electron

Objective: Chronic otitis media is a heterogeneous disorder. Chronic suppurative otitis media with cholesteatoma and, to a lesser extent, chronic otitis media with granulation lead to the destruction of bone structures within the middle ear. Bone loss may appear in the prominence of the horizontal semicircular canals and the bony canal of the facial nerve. The inflammatory process may spread to the bony labyrinth of the sigmoidal sinuses and the cranial cavities. Materials and Methods: The analysis comprised the examination of fragments of auditory ossicles removed during surgery in 21 patients with various types of chronic inflammation of the middle ear. The purpose of this study was to evaluate the usefulness of scanning electron microscopy in evaluating the erosion of middle ear ossicles in different types of chronic otitis media. Images captured at various magnifications were used for the best possible illustration of the observed lesions in bone tissue. Results: The observed lesions and the degree of bone surface damage were dependent on the type of chronic inflammation of the middle ear. The largest destructive changes in the ossicular chain were observed in chronic otitis media with cholesteatoma; smaller changes were observed in chronic otitis media with granulation. Conclusion: In the case of damage to the ossicles inflicted by inflammation, the use of a modeled bone block made of a temporal bone taken from outside the tympanic cavity or a biomaterial prosthesis is a good choice in ossiculoplasty.

scholarly journals Assessment of chronic suppurative otitis media patients with cholesteatoma on the basis of gadolinium enhanced T1-T2 weighted images of MRI

2019 ◽  
Vol 5 (4) ◽  
pp. 1020
Author(s):  
Sumeer Verma ◽  
Anshu Arora ◽  
Ajay Kumar Jain
Keyword(s):  
Otitis Media ◽  
Predictive Value ◽  
Early Stage ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Pars Flaccida ◽  
Retraction Pocket ◽  
Suppurative Otitis Media ◽  
Total Destruction

<p class="abstract"><strong>Background:</strong> The propensity for ossicular destruction is much greater in case of unsafe CSOM due to presence of cholesteatoma and/or granulations. Partial or total destruction of ossicles is seen in approximately 80% of patients with cholesteatoma, whereas in chronic otitis media without cholesteatom, ossicular chain erosion can be seen in approximately 20% cases.The present study aims to evaluate the clinical profile of patients of unsafe chronic suppurative otitis media with cholesteatoma and assesses patients on the basis of gadolinium enhanced T<sub>1</sub>-T<sub>2</sub> weighted images of MRI.</p><p class="abstract"><strong>Methods:</strong> The study was conducted among patients who were fulfilling the criteria for unsafe CSOM i.e., retraction pocket in pars tensa, marginal perforation, perforation in pars flaccida, presence of granulation tissue, presence of polyp, blood stained discharge etc. were selected for the study. MRI was performed in all cases by using gadolinium enhanced T<sub>1</sub>-T<sub>2</sub> sequences for diagnosis of cholesteatoma. Mastoidectomy was done to confirm the findings of MRI.  </p><p class="abstract"><strong>Results:</strong> In maximum number of cases perforation was found in attic region. Most common complication of disease is the ossicular chain erosion. In present study sensitivity was 84%, specificity was 100% and positive predictive value and negative predictive value were 100% and 66% respectively.</p><p class="abstract"><strong>Conclusions:</strong> It can be concluded that MRI can differentiate cholesteatoma from other inflammatory etiology. By using MRI with 1.5 or 3T unit a small cholesteatoma (even 2-3 mm) can be easily detected at its early stage and further complications can be prevented.</p>

scholarly journals Role of high resolution computed tomography of temporal bone in preoperative evaluation of chronic suppurative otitis media

2018 ◽  
Vol 4 (5) ◽  
pp. 1287 ◽  
Author(s):  
M. D. Prakash ◽  
Afshan Tarannum
Keyword(s):  
Temporal Bone ◽  
Otitis Media ◽  
Sensitivity And Specificity ◽  
Middle Ear ◽  
Preoperative Evaluation ◽  
High Sensitivity ◽  
Chronic Suppurative Otitis Media ◽  
High Resolution Computed Tomography ◽  
Suppurative Otitis Media ◽  
Middle Ear Cleft

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is a common condition seen in patients attending ENT department. The diagnosis of cholesteatoma is usually made on otologic examination. The necessity for HRCT imaging in an uncomplicated case is controversial. The objective was<strong> </strong>to evaluate preoperative HRCT temporal bone and to determine its’ usefulness in patients with Chronic suppurative otitis media (CSOM) undergoing surgery.</p><p class="abstract"><strong>Methods:</strong> This study was a prospective study involving 30 cases of CSOM with cholestaetoma. All the patients underwent pre-operative HRCT screening followed by surgical exploration of middle ear cleft. Pre-operative CT scan and intra-operative findings recorded and compared.  </p><p class="abstract"><strong>Results:</strong> Out of total 30 patients of CSOM, 16 (53%) were males and (90%) presented with chief complaints of otorrhoea. HRCT scan was found to be very sensitive (100%) in detecting cholesteatoma in middle ear cleft but differentiation between granulations or cholesteatoma wasn’t possible. HRCT satisfactorily delineated ossicular erosion except stapes suprastructure erosion which had 81.8% sensitivity and specificity 88.88%. For bony boundaries of middle ear, HRCT showed very high sensitivity and specificity for detecting scutum erosion, tegmen erosion, mastoid cortex erosion, jugular bulb dehiscence and bony external auditory canal erosion. It was moderately sensitive for LSCC Erosion (75%), Facial canal erosion (80%) and Sinus plate erosion (85.7%).</p><p class="abstract"><strong>Conclusions:</strong> These results indicate that preoperative CT temporal bone scan of patients with CSOM serves as an important guide in surgical approach for otolaryngologists, although there are limitations in evaluation of the CT results.</p>

scholarly journals Correlation of the Puretone Audiometry Findings with Intraoperative Findings in Patients with Chronic Suppurative Otitis Media

2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Number Of Patients ◽  
Operative Findings ◽  
Air Conduction

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. <strong>Aims and Objectives:</strong> 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. <strong>Materials and Methods:</strong> This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. <strong>Result:</strong> Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. <strong>Conclusion:</strong> Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.

Development of an ear cap in chronic suppurative otitis media using additive manufacturing and TRIZ

2018 ◽  
Vol 232 (7) ◽  
pp. 733-738 ◽  
Author(s):  
Mahesh B Mawale ◽  
Abhaykumar Kuthe ◽  
Anupama M Mawale ◽  
Sandeep W Dahake
Keyword(s):  
Hearing Loss ◽  
Additive Manufacturing ◽  
Otitis Media ◽  
Middle Ear ◽  
Prevalence Rate ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Collaborative Tool ◽  
Middle Ear Infection

The prevalence rate of chronic suppurative otitis media is high and its treatment continues to be a challenge for the otorhinolaryngologists. Due to middle ear infection, there may be pain, hearing loss and spontaneous rupture of the eardrum which results in perforation. Infections can cause a hole in the eardrum as a side effect of otitis media. The patients suffering from ear perforation or having a hole in eardrum require preventing entry of water in the ear. This article describes the development of ear cap using additive manufacturing and TRIZ (a collaborative tool) to prevent the entry of water in the ear during chronic otitis media.

Frequency of Incus Bone Erosion on Mastoid Exploration in Chronic Suppurative Otitis Media with Middle Ear Cholesteotoma

2021 ◽  
Vol 15 (6) ◽  
pp. 1426-1428
Author(s):  
W. Javaid ◽  
A. Rashid ◽  
M. U. K. Amin ◽  
T. Khan ◽  
M. Fatima
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bone Erosion ◽  
Age Groups ◽  
Chronic Suppurative Otitis Media ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Middle Ear Cholesteatoma ◽  
Sample Technique ◽  
Operative Findings

Background: Cholesteotoma is a benign but destructive lesion leading to ossicular necrosis. Objective: To see the frequency of incus bone erosion on mastoid exploration in chronic suppurative otitis media with middle ear cholesteotoma. Study Design: Cross-sectional descriptive study. Setting: This study was carried out in the Department of ENT Unit-2, Sir Ganga Ram Hospital, Lahore. Duration of Study: Fifteen months months (10th April, 2019 to 9th July, 2020) Sample technique: Non- probability purposive sampling Methods: One hundred and twenty patients were admitted through outpatient department of ENT Unit-2, Sir Ganga Ram Hospital Lahore. Patients were included after fulfilling the inclusion criteria and information was collected on a prescribed proforma. Finally during surgery under general anesthesia, the operative findings were noted to know the incus bone erosion after middle ear cholesteatoma formation in chronic suppurative otitis media. Results: A total number of one hundred and twenty patients of chronic suppurative otitis media with middle ear cholesteatoma were included. Out of which 80 (66.7%) were males and 40 (33.3%) were females(Table 1).The patients shown in table 2 were divided in six age groups (Table 2).Table 3 shows that the procedure of mastoidectomy was performed in 112 patients (93.3%) and modified radial mastoidectomy was performed in 8 patients (6.7%).Incus bone erosion in chronic suppurative otitis media with middle ear cholesteatoma in 102 patients (85%) and 18 patients (15%) have no incus bone erosion (Table 4). Conclusion: Ear discharge was the most common presenting characteristic of chronic suppurative otitis media with cholesteatoma. The majority of the cases had ossicular erosion, with the incus being the most common site of involvement. Males are more likely than females to develop cholesteatoma. Keywords: erosion of incus bone, Mastoid exploration, Chronic suppurative otitis media, Cholesteatoma

scholarly journals Investigation of the Presence of Biofilms in Chronic Suppurative Otitis Media, Nonsuppurative Otitis Media, and Chronic Otitis Media with Cholesteatoma by Scanning Electron Microscopy

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ercan Kaya ◽  
Ilknur Dag ◽  
Armagan Incesulu ◽  
Melek Kezban Gurbuz ◽  
Mustafa Acar ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Tissue Samples ◽  
Scanning Electron

Objective. Biofilms have been shown to play a major role in the pathogenesis of otolaryngologic infections. However, very limited studies have been undertaken to demonstrate the presence of biofilms in tissues from patients with chronic otitis media (COM) with or without cholesteatoma. Our objective is to study the presence of biofilms in humans with chronic suppurative and nonsuppurative otitis media and cholesteatoma.Study Design. In all, 102 tissue specimens (middle ear, mastoid tissue, and ossicle samples) were collected during surgery from 34 patients.Methods. The samples were processed for the investigation of biofilms by scanning electron microscopy (SEM).Results. Our research supports the hypothesis in which biofilms are involved in chronic suppurative otitis media, cholesteatoma, and, to a lesser degree, chronic nonsuppurative otitis media. There were higher rates in hypertrophic and granulated tissue samples than in normal mucosa. In addition, the presence of biofilms was significantly higher in the middle ear mucosa compared with the mastoid and ossicle samples.Conclusion. In the clinic, the careful use of topical or systemic antimicrobials is essential, and, during surgery, hypertrophic tissue must be carefully removed from normal tissue.

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